Organization
WAB
Active
Other names
SeniorCare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ALLYN MANUEL (PRESIDENT)
(843) 216-7000
Entity
Organization
Contact information
Practice address
1256 BEN SAWYER BLVD, SUITE E, MOUNT PLEASANT, SC 29464-4578
(843) 216-7000
(843) 216-3600
Mailing address
1256 BEN SAWYER BLVD, SUITE E, MOUNT PLEASANT, SC 29464-4578
(843) 216-7000
(843) 216-3600
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DE1243
—
SC
Enumeration date
07/21/2005
Last updated
08/22/2020
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